Hepatitis A and evidence against the community dissemination of Helicobacter pylori via feces.

Seroprevalence data from 1501 subjects was used to test the hypothesis that Helicobacter pylori may be transmitted by the fecal-oral route. Antibody to hepatitis A virus was used as a marker of fecal-oral exposure. Of the 1501 subjects, 35.5% were seropositive for both H. pylori and hepatitis A, 19.1% were seronegative for both, 36.5% were seropositive for hepatitis A only, and 8.8% were seropositive for H. pylori only. Cross-sectional data from rural areas supported an association between hepatitis A and H. pylori. However, in the urban area there was no evidence of hepatitis A infection in persons < 10 years old, yet the seroprevalence of H. pylori was high in this group (approximately 32%). From our data, we suggest that communitywide fecal-oral spread of H. pylori may be of limited importance.